Integumentary Disorders Q 3

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A male client is diagnosed with primary herpes genitalis. Which instruction should the nurse provide?

  

    A. “Apply one applicator of terconazole intravaginally at bedtime for 7 days.”

    B. “Apply one applicator of tioconazole intravaginally at bedtime for 7 days.”

    C. “Apply acyclovir ointment to the lesions every 3 hours, six times a day for 7 days.”

    D. “Apply sulconazole nitrate twice daily by massaging it gently into the lesions.”

    

    

Correct Answer: C. “Apply acyclovir ointment to the lesions every 3 hours, six times a day for 7 days.”

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A client with primary herpes genitalis should apply topical acyclovir ointment in sufficient quantities to cover the lesions every 3 hours, six times a day for 7 days. The benefits of acyclovir include its low side effect profile, which allows it to be tolerated for long periods. Suppressive treatment with acyclovir can prevent or delay up to 80% of recurrences, thus reducing shedding by greater than 90%.

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Option A: Terconazole is used to treat vulvovaginal candidiasis. There are also prescription therapies: nystatin 100000-unit vaginal tablet for 14 nights, terconazole 80 mg one suppository vaginally for 3 nights, terconazole 0.8% cream vaginally for 3 nights, butoconazole 2% cream one applicator vaginally once (do not use during the first trimester of pregnancy).

Option B: Tioconazole is used to treat vulvovaginal candidiasis. For vaginal candidiasis, several over the counter options are available: clotrimazole 1% cream vaginally for 7 to 14 nights, clotrimazole 2% cream vaginally for 3 nights, miconazole 2% cream vaginally for 7 nights, miconazole 4% cream vaginally for 3 nights, miconazole 100 mg suppository vaginally for 3 nights, tioconazole 6.5% ointment vaginally once.

Option D: Sulconazole nitrate is used to treat tinea versicolor. Topical medications are considered the first-line therapy for pityriasis versicolor. Topical treatments are divided into nonspecific antifungal agents (sulfur plus salicylic acid, selenium sulfide 2.5%, and zinc-pyrithione) that primarily remove dead tissue and prevent further invasion, and specific antifungal drugs, that have fungicidal or fungistatic effects.

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